Dr. Rubenstein, Mark Painter on urology-related ICD-10 changes
"ICD-10-CM coding denials have been increasing across the country as payers continue to refine edits," write Jonathan Rubenstein, MD, and Mark Painter.
Jonathan Rubenstein, MD
I understand that International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes are updated on October 1, 2023. Are there any changes in ICD-10-CM that we should be aware of for urology?
Great question; many are not aware that the ICD-10-CM year runs from October 1 until the end of September. For the 2024 edition, effective October 1, 2023, there were 395 new codes, 25 deletions, and 13 substantive revisions. Most of the changes will not affect the vast majority of urology practices. Below is a list of code additions to chapter 14, “Diseases of the genitourinary system N00-N99.”1,2
Mark Painter
Add N02.B Recurrent and persistent immunoglobulin A nephropathy
Add N02.B1 Recurrent and persistent immunoglobulin A nephropathy with glomerular lesion
Add N02.B2 Recurrent and persistent immunoglobulin A nephropathy with focal and segmental glomerular lesion
Add N02.B3 Recurrent and persistent immunoglobulin A nephropathy with diffuse membranoproliferative glomerulonephritis
Add N02.B4 Recurrent and persistent immunoglobulin A nephropathy with diffuse membranous glomerulonephritis
Add N02.B5 Recurrent and persistent immunoglobulin A nephropathy with diffuse mesangial proliferative glomerulonephritis
Add N02.B6 Recurrent and persistent immunoglobulin A nephropathy with diffuse mesangiocapillary glomerulonephritis
Add N02.B9 Other recurrent and persistent immunoglobulin A nephropathy
No Change N04.2 Nephrotic syndrome with diffuse membranous glomerulonephritis
AddN04.20 Nephrotic syndrome with diffuse membranous glomerulonephritis, unspecified
Add N04.21 Primary membranous nephropathy with nephrotic syndrome
Add N04.22 Secondary membranous nephropathy with nephrotic syndrome
Add N04.29 Other nephrotic syndrome with diffuse membranous glomerulonephritis
No Change N06.2 Isolated proteinuria with diffuse membranous glomerulonephritis
Add N06.20 Isolated proteinuria with diffuse membranous glomerulonephritis, unspecified
Add N06.21 Primary membranous nephropathy with isolated proteinuria
Add N06.22 Secondary membranous nephropathy with isolated proteinuria
Add N06.29 Other isolated proteinuria with diffuse membranous glomerulonephritis
Minor revisions to references and coding notes were also included in the chapter.
Code N35.812 (Other urethral bulbous stricture, male) was revised to N35.812(Other bulbous urethral stricture, male).
It should be noted that the list above is not inclusive. ICD-10-CM coding denials have been increasing across the country as payers continue to refine edits. The most common denial is for nonspecific ICD-10-CM codes in families with more specific coding options available. We encourage you to check with your EHR vendor to make sure all new codes and changes have been incorporated into your system.Further, it is imperative for at least one in your office to have access to all changes made to ICD-10-CM either through a system like AUACodingtoday.com and/or downloading these changes from CMS using the link above.We encourage you to review your ICD-10-CM coding patterns, shortcuts, and definitions throughout the year.
References
1. Centers for Medicare & Medicaid Services. ICD-10-CM/PCS MS-DRG v41.0 definitions manual. August 16, 2023. Accessed September 19, 2023. https://tinyurl.com/5d94d8xv
2. Centers for Medicare & Medicaid Services. 2024 ICD-10-CM. Updated September 6, 2023. Accessed October 4, 2023. https://www.cms.gov/medicare/coding-billing/icd-10-codes/2024-icd-10-cm
Coding Q&A: Billing for female total urethrectomy with complete cystectomy
January 5th 2024"When we think about a typical procedure for performing a radical cystectomy for cancer with an ileal conduit, that would typically involve lymph node dissection, and therefore CPT 51595 would be best chosen to report that combined procedure," write Jonathan Rubenstein, MD, and Mark Painter.
